Centers stop dispensing birth control

Planned Parenthood loses contract

The six Planned Parenthood centers in New Hampshire stopped dispensing contraception last week after the Executive Council rejected a new contract with the organization.

Planned Parenthood had operated under a limited retail pharmacy license that was contingent on having a state contract, said Steve Trombley, president and CEO of Planned Parenthood of Northern New England. Two weeks ago, the all-Republican Executive Council voted 3-2 against a new contract that would have provided the organization $1.8 million in state and federal money for the two years starting this month.

Executive Councilor Dan St. Hilaire of Concord, who cast one of the three votes in opposition, said the contract should go to an organization that does not perform abortions. The councilors approved 10 other contracts for family planning services.

The Planned Parenthood contract, which accounts for about 20 percent of its annual New Hampshire budget, would have paid for education, distributing contraception, and the testing and treatment of sexually transmitted infections. The organization's abortion practice is paid for by private donations, Trombley said, with audits ensuring no public money is used.

Last year, Planned Parenthood provided contraception for 13,242 patients in New Hampshire, Trombley said. The organization also provided 6,112 breast exams, 5,548 screenings for cervical cancer and 18,858 tests for sexually transmitted infections. If the contract is not renewed, Planned Parenthood will drastically reduce its services, Trombley said. The organization employs 80 people in New Hampshire.

Planned Parenthood treats 52 percent of patients whose care is subsidized by the New Hampshire state family planning program, Trombley said. It provides its services on a sliding scale based on income, with 70 percent of patients paying nothing or near nothing for birth control pills because they earn less than 150 percent of the federal poverty line. The federal poverty guidelines vary with the number of people in a household, with a single person qualifying at $10,890 per year and a family of four qualifying at $22,350 a year.

At the Planned Parenthood center in West Lebanon yesterday, Laura Caravella arrived to pick up her patient file to bring it to a physician. Caravella, a 25-year-old paraprofessional at an elementary school in Vermont, had tried to refill her birth control prescription last Friday and learned she could not.

She said she was concerned about the cost of her prescription without the sliding scale offered by Planned Parenthood.

"Financially it's really stressful," Caravella said. "I'm already living almost paycheck to paycheck as it is."

Stephanie Hiltunen, a 26-year-old who lives in Hanover, said she picked up a monthlong supply of birth control last Thursday, the day before the center stopped dispensing it. But future refills will require an inconvenient trip to Enfield, she said. Hiltunen said she would like to have a child but cannot afford it, and she worries there will be a public cost if contraception is inaccessible to low-income women.

"If they can't afford to have a baby, then we'll be paying for them in the long run," she said.

The center has turned away 20 to 30 patients a day who have arrived to refill their birth control prescriptions, said site manager Amanda Mehegan. She said some women have said they will stop taking birth control because they cannot afford the higher prices charged by pharmacies. Seventy percent of the center's patients lack private health insurance, she said.

Mehegan said she also worries the denied contract will lead to women with breast and cervical cancer going longer without a diagnosis, both because of direct cuts in funding for examinations and because many women are drawn to the center to pick up their birth control and then receive checkups.

"For most of our patients Planned Parenthood may be the only medical visit they have in a year," she said. "I think a lot of patients really rely on that as their yearly checkup."

Anne Hildreth, a practitioner at the West Lebanon center who has worked for Planned Parenthood for 22 years, said her goal is to help prevent unwanted pregnancies. She questioned the rationale of limiting access to contraception in an effort to prevent abortions.

"It's crazy to not give women birth control if you want to stop women from having abortions," Hildreth said.

Yesterday, Planned Parenthood launched an advertising campaign about the Executive Council vote in state newspapers. The advertisement in the Monitor asks St. Hilaire to "put women's health above politics" and shows a photograph of a young woman from Portsmouth who says she cannot afford birth control at pharmacies.

Trombley said the organization is focusing its efforts to pass the contract on St. Hilaire because the Concord councilor voted in favor of each of the family planning contracts except the one with Planned Parenthood. Officials from the organization met with St. Hilaire last week, but he made no commitment about a future vote, Trombley said.

St. Hilaire did not respond to messages seeking comment.

Another executive councilor who opposed the contract, Raymond Wieczorek of Manchester, said he had asked if the contract could exclude the issuance of condoms. Wieczorek said he supports paying to test for sexually transmitted diseases but does not believe the state should subsidize contraception.

"If they want to have a good time, why not let them pay for it?" he said.